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NevadaSB49483rd Regular Session (2025)SenateWALLET
AN ACT relating to state government; creating the Nevada Health Authority; creating certain divisions and offices within the Authority; providing for the appointment of officers and the employment of staff for the Authority; establishing requirements governing procurement by the Authority; creating the Nevada Health Authority Gift Fund; prescribing the duties of the Authority and its divisions and officers; transferring to the Authority the responsibility for operating various programs and administering various provisions; revising the name of certain agencies; revising certain terminology; eliminating the Division of Health Care Financing and Policy of the Department of Health and Human Services; revising provisions governing the operation of the Public Employees' Benefits Program and Medicaid; requiring certain reporting on the costs of health insurance for retired state employees; authorizing the Authority to require the reporting of certain information on the cost of certain prescription drugs; revising the membership and duties of the Board of Directors of the Silver State Health Insurance Exchange; providing for a study of opportunities for the Board of the Public Employees' Benefits Program to directly contract with certain providers of health care; providing for a study of and the development of a plan to transfer certain additional functions to the Authority; and providing other matters properly relating thereto.
Sponsored By: Senate Committee on Finance
Signed by Governor
BDR 18-1116
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96 provisions identified: 59 benefits, 9 costs, 28 mixed.
Minimum coverage for addiction treatment
Group health plans must cover substance use treatment at set minimums. You get up to $1,500 per year for withdrawal treatment. You get up to $9,000 per year when admitted to a facility. You get up to $2,500 per year for counseling when not admitted, paid like similar illnesses in licensed facilities.
Minimum substance use treatment coverage amounts
Individual health plans must cover set minimums for substance use disorder care. Each year, plans cover up to $1,500 for withdrawal treatment, up to $9,000 for inpatient treatment when admitted, and up to $2,500 for counseling when not admitted. Care must be in certified or licensed facilities, and benefits are paid like similar medical care.
Stronger Medicaid drug access and buying
The Authority creates a preferred drug list and can negotiate drug purchases for Medicaid, CHIP, and public plans that opt in. Medicaid must cover certain non‑preferred drugs like hepatitis C treatments, medication‑assisted treatment, and withdrawal‑support drugs. If all preferred drugs in a class are unsuitable for you, Medicaid must cover the non‑preferred option. After a failed trial of a preferred med, Medicaid automatically covers needed antipsychotics or anticonvulsants without extra approvals.
Higher license bonds for care facilities
Certain care facilities must post a surety bond when applying for or renewing a license. Bond amounts are $5,000 for under 7 employees, $25,000 for 7–25, and $50,000 for more than 25. The Administrator may waive bonds for some small residential homes if paying would cause hardship. Instead of a bond, you may deposit approved securities equal to the bond with a Nevada bank, if approved; interest stays with you. All applicants must use the licensing form set by the Health Care Purchasing and Compliance Division.
Easier access to Medicaid, CHIP, Exchange
The Nevada Health Authority adopts the state plans for Medicaid and CHIP. Qualified noncitizens who meet 8 U.S.C. § 1641(b) and Authority rules can get benefits. If your child’s CHIP application is denied, you get written notice, a hearing within 30 days if you ask, and 30 days to seek court review. The Authority can let other state, local, or tribal agencies do eligibility decisions and hearings under strict agreements and audits. The Director hires experts to build a plan for easier plan selection and real‑time enrollment through the Exchange, and reports progress by Feb 1 in odd‑numbered years.
Licensing protection for reproductive care
Licensing boards cannot deny or punish a license just for providing reproductive health care that is lawful and meets Nevada standards. Boards also cannot punish someone only because another state or D.C. disciplined them for that lawful care.
More help choosing Medicaid managed plans
For Medicaid managed care, the Authority only contracts with HMOs that negotiate in good faith with key public providers. It must publish plan comparison information and run a support system to help enrollees choose and use their plan. Some outside review rules do not apply to services under these contracts.
No disability bias in transplant coverage
Insurers cannot deny, limit, or avoid paying for organ transplant care because a person has a disability. They also cannot end eligibility or cut a provider’s pay to get around this rule. These protections apply to transplant‑related coverage and care.
Prenatal care for indigent pregnant women
The Authority can provide or pay for prenatal care at public or nonprofit hospitals for indigent pregnant women. It sets who qualifies and payment rates by rule. The Authority must tell social workers, Medicaid applicants, and others about this care.
Public plans can use state drug deals
Local government health plans and the Public Employees’ Benefits Program can adopt the Authority’s preferred drug list. They can also buy medicines through the Authority’s purchasing agreements after notifying the Authority. This can lower drug costs for covered workers and families.
Up to 12 months child care help
Low‑income families who lose certain benefits can get child care assistance for up to 12 straight months. Your personal responsibility plan must include child care payments, and the loss must be for reasons in 42 U.S.C. 608(a)(11). The help cannot last longer than 12 months under this rule.
Triple damages for illegal hospital refusals
If a hospital unlawfully refuses a patient and you treat that patient, you can recover three times your billed charges from the violating hospital. You can also recover reasonable attorney’s fees and costs.
Hospitals must report safety events on time
Facility staff must tell the patient safety officer within 24 hours after learning of a sentinel event. The officer must report to the state within 13 days, or within 14 days if the officer discovered it first. Each facility must send an annual summary by March 1, and the Authority posts each facility’s current patient safety plan. The state analyzes trends and posts updates at least quarterly. If a facility does not self-report, fines can be up to $100 per day for late reporting, $1,000 per month without a safety plan, and $2,000 per violation for committee failures; other reporting failures can bring fines up to $10,000 after a hearing. Audited facilities must pay the actual cost of audits.
Insurers and PBMs can’t penalize 340B
Health insurers and pharmacy benefit managers may not treat 340B drugs, covered entities, or contract pharmacies differently. They cannot add fees or clawbacks, pay less, kick them out of networks, raise cost‑sharing just for 340B drugs, or limit dispensing only for 340B. This protects safety‑net providers and the patients they serve.
Stronger health data and records rules
Health information exchanges must be certified by the Authority and follow rules for privacy, consent, and interoperability. The Director sets statewide standards for electronic health records, patient access, consent, security, and breach notices; providers may seek hardship waivers. Licensing boards can order fixes or fines for record‑rule violations, but not suspend a license just for that. Hospitals must use a standard discharge form and send monthly patient data; providers must keep records at least 5 years and cannot destroy records for people under 23. The Authority’s Office of Data Analytics manages health data tools to inform the public.
Stronger infection control at medical facilities
If a facility averaged 25 or more patients per business day last year, it must join the CDC safety tracking system within 120 days. Every facility must have an infection control officer and keep at least one trained employee per 100 occupied beds. Facilities with 175 or more beds must have a certified infection preventionist. Patients must get infection-risk information at admission, and public areas must show how to report facility-acquired infections.
Stronger oversight of hospitals and care facilities
The Health Authority’s compliance division investigates hospital violations and can sanction licenses. Licensed medical and dependent‑care facilities can be inspected anytime, with or without notice. The Division can ask a court to stop violations without proving money loss. Complaints are confidential unless charges are filed; final orders are public. The nursing board must share approved training lists and staff discipline with regulators. If a facility fails to follow NRS 439.589(4), the Division, after notice and a hearing, can order fixes or administrative penalties but cannot suspend or revoke a license for that subsection alone. The law also expands which places count as health facilities, adding chapter 449‑licensed sites and some community‑based homes.
Tougher enforcement on prices and HMOs
The Health Authority can make rules, hold hearings, and require facilities to file cost and pricing data. It can ask a court to quickly stop violations. If the Authority flags an HMO or provider for not meeting the community‑benefit rule, it must notify the licensing regulator. The Insurance Commissioner may order fixes or fine the HMO after a hearing, and regulators are told when the entity comes back into compliance. People who violate public‑health laws face misdemeanor charges. Local health officers who neglect enforcement can be fined up to $250.
Annual drug price report and fines
By Feb 1 each year, the Authority compiles drug lists, including key diabetes drugs and those flagged for price levels or increases. By June 1, it publishes a price report and holds a public hearing. Entities that fail to submit required drug data can be fined per day. Fines are up to $500 per day for in‑state pharmacies and sales reps, and up to $5,000 per day for manufacturers, PBMs, wholesalers, or nonprofits. Collected money funds transparency work and patient education.
Exchange moves under Health Authority
The Silver State Health Insurance Exchange is now in the Authority’s Consumer Health Division. It helps people buy qualified health plans, educates consumers, and assists small employers. The Exchange coordinates with Medicaid, CHIP, and other programs to create a single entry point and keep coverage from breaking when people switch programs. It can sign contracts, accept gifts, and follows state purchasing rules, except for certain Authority purchases.
Faster complaint referrals and patient‑safety rules
Boards must refer misdirected complaints within 5 days, and immediately if it’s an emergency. They must immediately alert the right health authority for public health emergencies. Sentinel events found by boards must be reported at once to the Health Care Purchasing and Compliance Division, and that information is confidential. Facilities must report privilege changes and disciplinary outcomes on tight timelines, and can be fined up to $10,000 per missed report after a hearing. During investigations, Authority investigators may view or listen to electronic monitoring from a patient’s living space.
Nevada Health Authority runs Medicaid
The Nevada Health Authority now runs Medicaid and CHIP as the state’s single agency. Duties from the old financing division move to the Authority, and the Department no longer runs these programs. The Administrator manages daily operations, benefits, and provider payments and can enforce rules on providers. The Authority also takes over key licensing and oversight duties from former health divisions. It must follow federal law and cannot deny or cut Medicaid or CHIP in ways that break federal rules.
New Nevada Health Authority runs health programs
The law creates the Nevada Health Authority to run Medicaid, CHIP, PEBP, the Exchange, and the Public Option. The Governor appoints a qualified Director, who names two deputy directors, and hires staff within the budget. Health duties shift from the old department to the Authority. Each year by Oct 1, the Director reports on operations, including hospital cost trends. The Authority can create provider billing codes to maximize Medicaid reimbursement and requires conflict‑of‑interest disclosures and recusals for providers it employs on Medicaid or CHIP work.
State claims database when federally funded
The Authority’s Office of Data Analytics can build an all‑payer claims database if federal money is available. It sets data, privacy, and security rules and may fine up to $5,000 per day for missing data. Contractors cannot collect direct patient identifiers and must meet HITRUST and applicable NIST standards.
Stronger Medicaid fraud control and enforcement
The Authority creates an Office of the Medicaid Inspector General to audit providers, prevent waste and abuse, and recover improper payments. The Authority enforces the Medicaid Plan and its rules, while the Attorney General keeps lead authority to investigate and prosecute Medicaid fraud and runs the Medicaid Fraud Control Unit.
Easier funding for doctor training
The Medical Education Council can sign a cooperative agreement with the Nevada Health Authority. This lets them move and disperse funds for graduate medical education. The goal is to support medical training and Nevada’s health workforce.
Medicaid estate recovery and property liens
Medicaid debts are prioritized in estates, and personal representatives must pay them once funds are available after a sworn statement. The Authority can ask a court to place liens on property and may foreclose as federal law allows; notice rules apply. Property passed outside probate, including deeds upon death, can still be used to repay Medicaid, and beneficiaries must notify the Authority, which responds within 45 days. Small‑estate affidavits must account for Medicaid debts, and the Director is an interested party in probate; set‑aside cases must notify the Director.
Medicaid estate recovery and spouse orders
Every Medicaid application must warn that payments can be recovered from the recipient’s estate or spouse, and that signers can be personally liable if they fail to report required facts. In probate, the Authority can add or change a Medicaid claim any time before the final account is filed. When someone applies for Medicaid for an institutionalized spouse, the Division must be served with the court papers and can intervene within 45 days.
Stronger overpayment recovery and planning limits
Medicaid is now treated like other public assistance for overpayment recovery. If Medicaid paid in error, you or your estate can be required to repay. Private agreements that split income or resources are not binding on Medicaid eligibility or resource decisions.
New fines and discipline for licensees
After an investigation and hearing, the Division may put a licensee on probation, publicly reprimand them, refuse renewal, suspend or revoke the license, or fine up to $500 per violation. Disciplinary orders are public records. Private reprimands are not allowed.
Benefit rules for noncitizen residents
The Authority follows 8 U.S.C. 1621, so it is not required to pay Medicaid or CHIP for people who are ineligible under that federal law. Qualified noncitizens who meet federal rules can get TANF and other programs funded under 42 U.S.C. 1397, as allowed by Department rules. This sets clear federal‑based limits and access for noncitizens.
Medicaid drug list: key access, reviews
The preferred drug list must include drugs for sickle cell disease and HIV prevention. HIV treatments, transplant anti‑rejection, and antihemophilic drugs are excluded from restrictions. New drugs, or drugs with new evidence, need prior authorization until reviewed.
Program funding checks and gift fund
On or before July 1 of every odd year, the Authority checks if there is enough money for parts of its health programs. It may pause some components if money is not enough, except those protected by law. The Authority can take gifts and grants to keep services going. A Gift Fund holds these dollars and must spend them only for health care, following donor terms.
New rules for music therapists
The Health Care Purchasing and Compliance Division now licenses and polices music therapists. The first license costs $200, and you renew every 3 years with 100 continuing‑education units and current certification. Each licensing fee is capped at $250, and any fee increase must only cover program costs. You must list your Social Security number and submit a child‑support statement. Licenses can be denied or suspended for child‑support noncompliance; suspension starts 30 days after a court order unless a compliance letter arrives. If your renewal is late, the Division sends certified notice within 30 days; you have 60 days to renew before the license expires. Using the title “music therapist” without a license is a misdemeanor. The Division investigates complaints, can discipline for fraud, negligence, or other listed misconduct, and keeps complaint records for at least 10 years. Any optional renewal data is confidential and you cannot be punished for skipping it.
Updated licensing rules for dietitians
The Division now handles licensing and enforcement for dietitians and must act on qualified applications without unnecessary delay. Licenses expire every 2 years. To renew, file the form, pay the fee, keep credentials in good standing, and complete required training. New applicants must be registered dietitians in good standing, pay the fee, and submit two fingerprint cards for state and FBI checks. You must include your Social Security number and submit a child‑support statement; the Division will not issue or renew if you report noncompliance. The Division may issue a 10‑day temporary license to out‑of‑state dietitians whose requirements are substantially equal. The Division keeps public records of decisions. The Board sets professional and competence standards, and the Division may evaluate licensees, accept grants or contracts to run the program, and the Board may create an unpaid Dietitian Advisory Group. Optional online renewal data is confidential and you cannot be disciplined for not providing it.
Tougher antifraud rules for Medicaid providers
The Director must give the Medicaid Fraud Control Unit records and refer suspected crimes. Providers found to commit certain offenses can be suspended or excluded for at least 3 years, even without criminal charges. The Director may also exclude providers who do not follow state law. This protects program funds but increases compliance risk for providers.
Counties can fund extra Medicaid hospital pay
Counties with 100,000 or more people can transfer indigent medical funds to the Authority for supplemental Medicaid payments to public hospitals, if allowed by the State Plan and federal rules. This can boost hospital funding and access but uses county indigent funds for those payments.
County grants for public hospitals
In counties with 700,000 or more people, the county may grant up to the revenue from 2 cents per $100 of assessed value to public hospitals. Money can fund land, buildings, big equipment, or renovations. It cannot pay for normal, recurring maintenance.
Clear drug list info during enrollment
Your insurer must tell you if it uses a drug list and how to get it. If you ask, it must say if a drug is covered and give the current list. During open enrollment, the insurer must publish the Authority’s essential diabetes drugs and list any drugs removed or planned for removal, and keep that notice updated.
Fairer crime victim payments for survivors
For victims of domestic violence, sexual assault, and sex trafficking, the state will not weigh the victim’s conduct when deciding compensation. This helps eligible survivors get aid without being blamed for the harm.
Simple guide to senior care options
The Health Authority provides a brochure and website to help people 55+ compare housing and care. It lists care levels, shows whether facilities take Medicare or Medicaid, and explains how to find any violation history.
Group homes must list complaint contacts
Residential group home contracts must explain how to file complaints. They must list contacts for the Aging and Disability Services Division and the Health Care Purchasing and Compliance Division.
Medicaid covers doula care; enroll
Doula services are eligible for Medicaid payment when the doula is enrolled with the Medicaid Division. Doulas who serve Medicaid patients must enroll with the Nevada Health Authority to bill. This can lower out‑of‑pocket costs for pregnant people on Medicaid and create a clear billing path for doulas.
Notices for diabetic dental waiver
If the Authority gets the waiver for diabetes‑related dental care, HMOs and MCOs that serve Medicaid must send written notice to eligible recipients with diabetes. They must coordinate so eligible people receive the covered dental services.
Protections for staff who report safety
Health care employers and physicians cannot punish workers who, in good faith, report safety problems or sentinel events, refuse unsafe acts, or cooperate with investigations. Banned actions include demotion, pay cuts, suspension, firing, transfers, or frequent bad schedule changes.
Automatic voter registration during Medicaid application
When you apply for Medicaid through the Authority and give the usual information that shows you qualify to vote, the agency registers you to vote automatically. The agency cannot ask for extra information beyond what is normally collected and does not send your data if eligibility info is incomplete.
Annual health inspections of state institutions
The Health Authority oversees sanitation and safety at prisons, mental health centers, youth facilities, and higher‑education sites. The Chief Medical Officer or a designee must inspect them at least once a year and as needed. They may enter to check conditions and enforce rules. Inspection reports for state juvenile detention facilities must be published.
Faster safety reporting by doctors and hospitals
Osteopathic doctors must report surgeries using deeper levels of anesthesia at license renewal and report any related sentinel event within 14 days. Hospitals and clinics must report changes in a practitioner’s privileges within 30 days, or within 5 days if tied to competency or suspected substance use. Court clerks must report certain findings within 45 days. These reports help regulators protect patient safety.
Felony penalties for benefit fraud
It is a felony to knowingly get $100 or more from Medicaid, CHIP, or public assistance by lying, hiding facts, or impersonation. Restitution is required unless another penalty applies. These rules aim to protect limited benefit dollars and program integrity.
New Patient Protection Commission and data plan
The law creates a Patient Protection Commission inside the Nevada Health Authority. The Director, with the Governor’s approval, appoints its Executive Director, who has health care or insurance experience and may hire staff. The Commission writes and updates a yearly plan to increase patient access to records and make records work across providers, following HIPAA. It can ask any state or local agency for up to two reports a year on health costs, consolidation, or access, and those agencies must share when allowed by law. Every six months, the Commission reports on its work by January 1 and July 1, and the Governor posts the reports online. It also coordinates state data efforts to reduce duplicate work and improve public access to health data. For this chapter, “Authority” means the Nevada Health Authority.
Plumbing code updates go to Authority
When a city or county adopts the Uniform Plumbing Code, the State Public Works Board must review it and send a copy to the Nevada Health Authority. The Authority’s plumbing code and rules serve as the reference for how the code applies.
Public hospital and surgery center report cards
The Nevada Health Authority runs public programs to compare hospital and surgery‑center quality and charges. Facilities must send required data no later than 45 days after each month. The Authority posts a website that lets people compare by location, diagnosis, and treatment. It updates the site at least every quarter. Data include counts, standard quality measures, infection practices, readmissions, and billed charges. The Authority aggregates data so no patient is identified, and it notifies facilities that fail to report or report wrong data.
Safer, certified domestic violence treatment programs
The Authority certifies and monitors programs that treat people who commit domestic violence. Programs must include a victim‑safety module and use proven, evidence‑based practices. The State Board of Health sets rules and may charge fees. Out‑of‑state programs can be certified to serve Nevada residents when ordered by Nevada courts.
Secure site for background checks
The Division may run a secure website for background checks required by Nevada law. Users must make an account and name an administrator. Information is confidential and must meet state IT standards. Division and Public Safety staff may serve as administrators.
State OK for big builds and closures
In small counties and certain small towns, new health‑facility construction over $2,000,000 needs written approval from the Authority’s Director. In large counties, a hospital cannot close or convert without that approval. The licensing division cannot issue or change a license for these projects without the approval. Breaking these planning rules can bring civil fines: up to 10% of a project’s planned cost for licensing‑project violations, or up to $20,000 per other violation.
Stronger privacy for electronic health records
The law bans using or sharing identifiable health data from electronic records or exchanges for non‑care or marketing. Unauthorized access is a misdemeanor and creates civil damages. You cannot be forced into a health information exchange. Your records can be retrieved only after you are fully told and you give clear consent as the Director requires. Minors’ confidential care is not shared with parents without the child’s consent. The Authority must set complaint rules, post how to file HIPAA complaints, and notify patients of any breach.
Written consent required in fertility care
Fertility clinics must have written agreements with both the patient and the donor before using human reproductive material. Violations can lead to civil penalties up to $10,000 for each violation, plus fees and costs. When penalties are imposed, the Attorney General notifies the Nevada Health Authority or the relevant licensing board.
More help to build health facilities
The law creates two funds for public health building projects. One holds federal dollars and pays bills; the other adds state help based on need. State aid cannot exceed the sponsor’s share, and projects must also qualify for federal aid. For federal requests, the Authority gives at least 10 days’ notice, hears applicants, and reviews by need. It inspects work, certifies payments to release federal money, and consults Public Works before new building or safety rules.
State centralizes health facility planning
The Nevada Health Authority now leads statewide planning for public and nonprofit health facilities. It will list current facilities, study where new ones are needed, and build programs to meet those needs. The Authority can set rules, hire staff, inspect, and accept grants and gifts into a new gift fund. It can also apply for and spend federal money for surveys, planning, and construction.
Competitive grants for medical residencies
The Authority’s Consumer Health Division runs a competitive grant program for in‑state residencies and postdoctoral training. The Advisory Council, housed in the Division, reviews applications and favors programs that can stay when federal funds end. The Authority manages the program account and can accept gifts and grants. The state’s OSIT Director administers GME grants funded by the Legislature.
Medicaid doulas must report abuse
Doulas enrolled to serve Medicaid recipients are mandatory reporters. When they know or reasonably suspect child abuse or neglect, they must report it within 24 hours.
More local and recipient Medicaid input
A Medical Care Advisory Committee advises the Medicaid Division and works to involve recipients in policy and program decisions. Counties with 700,000 or more people must create a reinvestment advisory committee with local and nonprofit members. Public employees on these committees get administrative leave without losing pay.
Nevada Health Authority takes charge
The new Nevada Health Authority now runs Medicaid and other listed health programs. The old Division of Health Care Financing and Policy is eliminated. State laws now refer to the Authority and its Director, and the Department is renamed the Department of Human Services. The Administrator must have proven experience in health financing and Medicaid.
New governance for state employee benefits
Two employee seats on the Public Employees’ Benefits Program Board are now appointed by legislative leaders. Appointed members serve four‑year terms and serve at the pleasure of who appointed them. The Director appoints the Executive Officer with the Governor’s approval, after Board interviews, and supervises the role. The Executive Officer must send annual reports with audited financials and, every two years, an actuarial valuation and legal review to state leaders.
New leaders and plan for oral health
The Authority appoints a State Dental Health Officer and a State Public Health Dental Hygienist. They assess needs and advise on statewide oral‑health programs. The Authority runs oral‑health work like data, education, coalitions, access to care, and school program recommendations. The position may be funded with gifts and grants.
New Nevada Health Authority leadership and powers
The law creates the Nevada Health Authority and puts it in charge of many state health programs, including Medicaid. The Director appoints full‑time leaders for each division and can set federal‑required state plans that define who qualifies and what help is offered. The Authority can accept gifts and grants in a new Gift Fund. Terms are updated in law to reflect the new agency structure.
Oversight of Medicaid reinvestment for housing
Local advisory committees review how Medicaid managed care reinvestment funds are spent and track efforts on homelessness, housing, and social needs. Each committee files a report by December 31 each year to state leaders with uses of funds and recommendations.
Single statewide 2-1-1 help line
The state maintains one statewide 2‑1‑1 number for non‑emergency help and referrals. The system includes the licensing status of health care facilities and updates that information at least every quarter.
State health data and IT upgrades
The Authority’s Director is the state lead for health information technology. The Director can set up or contract with health information exchanges and create statewide master lists of patients, providers, and payers. Data and analytics work moves to the Authority’s Office of Data Analytics.
State program to improve oral health
The Authority runs a State Program for Oral Health to teach residents about good dental care and disease prevention. A 13‑member Advisory Committee guides the program and files a report each year by July 1. The Authority can contract with experts, accept grants and donations, and seek federal waivers. All program money sits in a dedicated state account and does not expire each year.
Stronger Medicaid investigations and rulemaking
The Director can take sworn testimony and issue subpoenas to check eligibility, treatments, payments, and recover improper Medicaid benefits. Courts can force compliance. The Director can adopt rules to run programs. Before changing public‑assistance rules, the Authority must give at least 30 days’ notice, share the text, take comments, and keep minutes and recordings. Objections to procedure must be raised within 2 years after the rule takes effect.
Stronger oversight of health facilities
The Authority can set statewide minimum rules for running health facilities, which replace conflicting local rules. Facilities taking federal construction aid must meet these standards. The state licensing board must send surgery and sentinel‑event reports to the Authority, which keeps them confidential as required.
Guardianships must notify Medicaid; court OK
If a proposed protected person has received Medicaid, the guardianship petition and citation must be served on the Director. Before a guardian pays a Medicaid recovery claim for an adult or a minor, the guardian must get a court order. These steps add notice and court review before Medicaid recovery payments are made.
PEBP board changes; replacement rules exempt
Two PEBP board seats end June 30, 2025, and new members are appointed with staggered terms. PEBP is exempt from state rules that normally require a new group plan to keep people covered and benefits at least as extensive as the old plan.
Licenses tied to child support compliance
If you apply for a license or certificate handled by the Health Care Purchasing and Compliance Division, you must give your Social Security number. You must also submit the child support statement required by state law. The Division will not issue or renew the license if you do not file the statement or you are not in compliance with a child support order.
Counties pay more for health services
Each county must pay quarterly assessments to the Nevada Health Authority for local public health services. A county can ask to do the services itself, but needs approval from the Governor and the Interim Finance Committee, and any exemption starts at least 6 months later. In counties under 700,000 people, the required indigent‑care allocation rises 4.5% each fiscal year over the prior year.
Higher health licensing and review fees
The State Board of Health may set fees for licensing, certification, inspections, permits, plan reviews, and staff certifications. Fees are set to meet the approved budget revenue for the Division and the Health Care Purchasing and Compliance Division.
Medicaid privacy rules and HIV sharing
The Authority must limit the use and sharing of your application and case records to what is needed to run the program. If you have HIV and apply for or receive Medicaid, your HIV‑related medical information may be shared with the Authority.
Public assistance rules and oversight updated
The law updates “public assistance” to list programs like TANF, SNAP, child care aid, and energy help; Medicaid and CHIP are not counted in that term here. The Administrator can issue subpoenas, take testimony, and require records to check eligibility. The law replaces “welfare” with “public assistance” in agency duties. Gifts and grants for assistance are deposited in the state account and spent as the gift requires.
Medicaid liens: new state contact named
If you received Medicaid and pay to reconvey property, the county treasurer now works with the Director of the Nevada Health Authority. This replaces the prior agency named for that step. It does not change the payment or recovery rules.
Fraud warnings on medical claim forms
Hospitals and health professionals must include fraud-warning language on certain claim forms. The warning explains that false or misleading claims may bring criminal and civil penalties. Not having the warning is not a defense against fraud charges.
Approved cultural competency training only
Required cultural‑competency training must use a course the Health Authority approves. The Authority keeps and shares a list of approved courses. Facilities can apply to use a new course. The Authority must approve or deny it within 10 business days and reports average approval time each year. The rule applies to staff with weekly patient contact unless already completed as part of continuing education.
Food and bar rules eased, safety enforced
Non‑public meat, poultry, or fish rooms may use treated sawdust if approved and cleaned daily. The Authority can approve alternate alcohol‑warning wording and give out donated signs that meet size and type rules. Selling diseased meat or shellfish in unstamped containers is a gross misdemeanor.
New rules for patient transport businesses
The Nevada Health Authority now handles certain transport contracts tied to health programs and steps in to provide safety inspections if a public entity cannot. The change clarifies when carriers are exempt from some certificate requirements. It mainly changes which state office transport operators work with.
When these changes take effect
Most sections of this law take effect July 1, 2025. Sections 110 and 355 take effect January 1, 2026. Section 360 takes effect July 1, 2025 only if AB 519 is enacted and effective. Existing rules, contracts, and actions keep working after agency transfers until changed by the new agency.
Hospitals must post prices and finances
Hospitals must file yearly balance sheets and income and expense reports with the Nevada Health Authority. Hospitals with 100 or more beds must also file capital plans, community‑benefit details, and other finance policies. The Director can set dates, require CPA review, and post non‑privileged reports online. Every hospital must keep its full charge master available to the Director, contracted or billed payers, and state agencies, and send an electronic copy on request. The Authority reviews it but generally does not publish the full charge master.
Insurance enforcement shifts to Health Authority
The Health Authority, not the old agency, now alerts the Insurance Commissioner when an insurer breaks a specific health data rule. The Commissioner can order fixes or fine the insurer or administrator. For that rule alone, the Commissioner cannot suspend or revoke an HMO’s license just for that failure.
Liability shields for health data errors
The Health Authority and its staff are not liable for acts, omissions, errors, or technical problems that cause missing or wrong consumer information. The APCD office has similar protections. People and entities that submit data are also shielded from civil or criminal liability unless they disclosed information in bad faith or to cause harm. These rules support data sharing but reduce lawsuits over bad information.
How Nevada Health Authority runs now
The Health Authority is not treated as a standard state “using agency” for purchasing, unless a special section applies. The Director must sign any contract that spends federal Medicaid money, or it is void. The Authority can use the secure background-check website without fees. It is treated as a third-party payer for Medicaid and CHIP to aid data sharing and billing. Some reporting rules in this act apply right away and certain older statutes are repealed on July 1, 2025. Contract changes in the cited Medicaid section apply to agreements made on or after July 1, 2025. Current board appointees finish their terms after July 1, 2025, and one domestic violence committee seat shifts to an Authority division appointee on that date. If another new law already moved food-safety duties elsewhere, this act does not move those specific duties to the Authority.
Centralized health purchasing and contracts
The Authority runs its own purchasing. It can post bids on its website, join other governments’ contracts, and require bid bonds up to 5% and contract bonds up to the full contract value. The Health Care Purchasing and Compliance Division takes over AB 519 duties and new session grants tied to provider shortages and Medicaid/CHIP work.
County Medicaid payments and exemptions
For counties under 100,000 people, the Authority’s Director sets the county payment for the nonfederal Medicaid share, capped at what 8 cents per $100 of assessed value would raise. If a hospital district spans counties, the county where the hospital sits sends treatment payments to the Authority. Counties with an exemption approved by June 30, 2025 keep that exemption from the new Section 30 assessment for the rest of its term.
Drug purchasing deals and tighter formularies
The Authority reports each year by February 1 on its prescription drug purchasing deals and posts the results online. The corrections board and nonprofit health plans can choose to buy drugs through the Authority’s contracts and use its preferred drug list. The state Formulary Board has final say on which drug classes are on the preferred list and which drugs may be limited or exempted to protect continuity of care.
New leadership and oversight for Exchange
The Authority’s Director, with the Governor’s approval, appoints the Exchange’s Executive Director, who runs daily operations. The Board reviews key reports and publishes a public summary each year by December 31. Incumbent Board terms end June 30, 2025, and new staggered terms start July 1, 2025. State agencies must support the Authority and Exchange and share information as needed.
New makeup for the Exchange Board
The health insurance Exchange Board now has seven voting members and one nonvoting member. Seats are split among state leaders and agency heads or their designees, with experience rules for voters. Appointed members serve three years, can be reappointed once nonconsecutively, and can be removed for neglect or misconduct. The Board elects a Chair and Vice Chair for one-year terms, with only one reelection allowed for each role.
New rules for state employee health program
The Board running the state employee health program gets new tools and guardrails. It can use the Health Authority’s buying process and is not under the usual state purchasing rules when it does. Proposal reviews may happen in closed sessions, but final awards must be made in public. When a court-reported transcript exists, the Board must post it within 30 days. The Board can create advisory committees. The Executive Officer must meet set education and 5+ years’ leadership experience. Hiring is limited to available funds and unclassified hires need the Director’s approval.
Streamlined hearings, rulemaking, and data sharing
Some state hearing rules no longer apply to cases over facility approval letters, which can speed decisions. The Authority’s Medicaid regulations are exempt from certain adoption steps, as allowed by law. The Authority may share confidential information across its divisions and with local agencies that collect debts, while keeping legal privacy protections in place.
Sponsors & Cosponsors
Sponsor
Senate Committee on Finance
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
House vote • 6/1/2025
Final Passage - Assembly (1st Reprint)
Yes: 42 • No: 0
Senate vote • 5/30/2025
Final Passage - Senate (As Introduced)
Yes: 21 • No: 0
Actions Timeline
Chapter 514.
6/11/2025legislatureApproved by the Governor.
6/10/2025legislatureEnrolled and delivered to Governor.
6/6/2025legislatureTo enrollment.
6/4/2025SenateAssembly Amendment Nos. 948 and 954 concurred in.
6/2/2025SenateIn Senate.
6/2/2025SenateTo Senate.
6/2/2025HouseFrom printer. To reengrossment. Reengrossed. Second reprint.
6/2/2025HouseTo printer.
6/1/2025HouseRead third time. Passed, as amended. Title approved, as amended. (Yeas: 42, Nays: None.)
6/1/2025HouseDispensed with reprinting.
6/1/2025HouseRead third time. Amended. (Amend. Nos. 948 and 954.)
6/1/2025HousePlaced on General File.
6/1/2025HouseTaken from Chief Clerk's desk.
6/1/2025HousePlaced on Chief Clerk's desk.
5/31/2025HouseTaken from General File.
5/31/2025HouseRead second time.
5/31/2025HousePlaced on Second Reading File.
5/31/2025HouseFrom committee: Do pass.
5/31/2025HouseRead first time. Referred to Committee on Health and Human Services. To committee.
5/30/2025HouseIn Assembly.
5/30/2025HouseTo Assembly.
5/30/2025SenateFrom printer. To engrossment. Engrossed. First reprint.
5/30/2025SenateRead third time. Passed, as amended. Title approved, as amended. (Yeas: 21, Nays: None.) To printer.
5/30/2025SenateReprinting dispensed with.
5/30/2025Senate
Bill Text
As Enrolled
As Introduced
Reprint 1
Reprint 2
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